Characterization of a new pulmonary vein variant using magnetic resonance angiography: Incidence, imaging, and interventional implications of the "right top pulmonary vein"

Lars Lickfett, Ritsushi Kato, Harikrishna Tandri, Vinod Jayam, Chandrasekhar R. Vasamreddy, Timm Dickfeld, Thorsten Lewalter, Berndt Luderitz, Ronald D Berger, Henry R Halperin, Hugh Calkins

Research output: Contribution to journalArticle


Introduction: Catheter ablation of the pulmonary veins (PVs) for prevention of recurrent atrial fibrillation requires precise anatomic information. We describe the characteristics of a new anatomic variant of PV anatomy using magnetic resonance angiography. Methods and Results: A 1.5-T magnetic resonance imaging system with a body coil or a torso phased-array coil was used before and after gadolinium injection. Magnetic resonance angiograms were acquired with a breath-hold three-dimensional fast spoiled gradient-echo imaging sequence in the coronal plane. Three-dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. A newly described variant PV ascending from the roof of the left atrium was found in 3 of 91 subjects. The mean ostial diameter of the roof PV was 7 ± 2 mm, the mean distance from the ostium to the first branching point was 22 ± 8.5 mm, and the mean distance to the right superior PV was 3.3 ± 0.6 mm. Conclusion: We refer to the newly described variant of PV anatomy as the "right top pulmonary vein." It is important to be aware of this anatomic pattern to avoid inadvertent catheter intubation, which can result in misleading mapping results and PV stenosis.

Original languageEnglish (US)
Pages (from-to)538-543
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Issue number5
StatePublished - May 2004



  • Ablation
  • Anatomic variant
  • Atrial fibrillation
  • Magnetic resonance angiography
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this